"We need to get the message out that this is the most common chronic infectious disease in children and it's on the upswing," said Alexandra Hall, a dental hygienist and coordinator for the Eastern Shore Children's Regional Oral Health Consortium. "It's totally preventable but we need parents on board."

According to the Centers for Disease Control, the percentage of children between 2 and 5 with dental cavities has increased from 24 percent from 1988 to 1994 to 28 percent from 1999 to 2004. children even younger than that are having problems with cavities, Hall said. She said because the Eastern Shore is a rural, underserved area, dental decay in young children is an increasingly large problem.

Debbie Goeller, of the Worcester County Health Department, reported that a recent screening of Head Start students found that 33 to 36 percent of children had class one or class two dental disease. Class one dental disease requires serious and urgent care, while class two disease means a dentist appointment should be scheduled.

Dr. Scott Wolpin, the chief dental officer for the Choptank Community Health Sys-tem, said he has found even more alarming statistics.

"After screening over a 1,000 school-aged children of the rural counties of the Eastern Shore, I have found an average of 60 percent of all children to have untreated dental disease and 15 percent are experiencing pain and/or swelling while attending school," he said in an e-mail.

The high percentages of children with dental decay are the result of several factors.

Many towns on the shore do not have fluoridated water, which helps prevent cavities.

"Worcester County has the smallest percent of its population on fluoridated water in the state," Goeller said.

In addition to the lack of local fluoride, most parents are not aware just how easily their dental health can directly impact their child's dental health.

In order for a child to get a cavity, he or she must first be exposed to the bacteria that causes cavities, Hall explained. Once a baby has been exposed to that bacteria, all it needs to develop a cavity is a tooth, or part of a tooth, and carbohydrates that break down into sugar.

The surprising fact to most adults is that it is usually a parent who passes the cavity-causing bacteria on to an infant. Anyone who has active dental decay in their mouth can pass the germs to a child, through actions such as kissing or sharing food, Hall said. She suggests women visit a dentist when they find out they are pregnant so any active decay can be dealt with before childbirth.

"Infants should only have to be worried about diaper rash, not tooth decay," Hall said.

Once a child is born, his or her teeth, as soon as they start to grow in, should be wiped clean after eating, Hall said. Usually when a child is two, a parent should start brushing his or her teeth with a rice-sized smear of fluoride toothpaste.

"Generally we recommend that at the child's first birthday there be a dental exam," Hall said, "but the trouble is we don't have enough providers to do this."